Exocrine Pancreatic Insufficiency is the progressive loss of gland cells from the pancreas leading to decreased production of digestive enzymes and therefore reduced absorption of nutrients from the gut. The condition can occur at any age and across a range of breeds however there is a particularly high incidence in young German Shepherds which may be an inherited predisposition. The actual underlying reason for the loss of pancreatic cells is unknown but nutritional imbalance or destruction of cells secondary to disease and toxins have been proposed as possible causes. Not only are the digestive enzyme levels reduced but changes occur in the intestinal lining and the bacterial population which further reduce s its absorptive ability. Concurrent diabetes due to loss of insulin producing cells is also occasionally seen in effected dogs.

The clinical signs are gradual weight loss despite normal or increased appetite; diarrhea varying from bulky soft faeces to very watery explosive motions; flatulence, abdominal pain and sometimes coporphagia (eating faeces).

Diagnosis is based on history and clinical signs supported by laboratory testing and response to treatment. Direct measurement of pancreatic enzymes in the blood is very accurate but not widely performed due to cost and complexity of the testing. Examination of the faeces for the presence of undigested starch, muscle fibre and fat has been a traditional method for identifying pancreatic insufficiency however this is only moderately accurate.

Replacement enzymes are used to treat the insufficiency often in combination with a highly digestible diet. These enzymes are usually derived from either pig or cattle pancreas and are fed as powder or tablets with each meal. Where the response to this therapy is only partial, antibiotics directed at abnormal bacterial overgrowth of the intestine should be considered.